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Do I need to fill out a Health History Evaluation and Vaccination History Form?

Under the Occupation and Health Saftey Program, ALL SIUE faculty, staff, and students who have, or plan to have, regular contact with live vertebrate laboratory or wild animals, must have a current medical history, physical examination, and appropriate vaccinations/testing PRIOR to exposure to the animals. These requirements fall under the rules set in place by the Office of Laboratory Animal Welfare (OLAW). 

The majority of Part A should be filled out by your physician after they have reviewed the Part B form that you filled out. ONLY Part A will be returned to our office.  This form is good for 6 years. Please note, that this form should not be signed off by a health care provider without a physical examination first. 

It may be beneficial to bring the Letter of Explanation to your physician, so they are clear on what is needed during the appointment.  

A common misconception with the health history form is that the vaccination declination form can be filled out and turned in, in place of the health history form. This isn't accurate. A health history form must be completed regardless of vaccination status. The vaccination declination form is only used once your health care provider has conducted their assessment, recommended a vaccine based on the animals involved, etc. It's only have a health history form has been completed by a health care provider can someone formally refuse the recommended immunizations. 

If you have any questions about this process or the forms, please reach out to researchcompliance@siue.edu. 

All these forms can be found on our website here